H1N1CA

=Content Analysis for Giving H1N1 a Shot in the Arm - House Style = Melissa D. The smallest unit of information || 1. Virus – a microscopic infectious agent that replicates in host cells and can cause disease 2. Vaccine – actual substance that is injected into body || []
 * ** Content Type ** || ** Content Elements ** || ** Game/Simulation Elements ** ||
 * ** Facts **

Basic health science knowledge that participant may be required to explain to patient. (choosing responses to patient questions) || Categories of things with a common name and critical attributes || 1. Vaccination – live virus (tiny amounts) or killed virus is injected into the body to trigger the development of antibodies to fight off infection and prevent illness a. live virus b. inactivated virus 2. “Flu” – disease caused by various strains of the influenza virus; spreads from person to person 3. Seasonal flu – variations of common influenza virus that circulate yearly, changing slightly from year to year. Seasonal flu vaccine is based on prior year strains and what experts think is most likely to spread in the coming year. 4. Healthcare worker – trained and knowledgeable individuals or systems providing medical care to patients to prevent or treat illness and disease (typically licensed or certified) <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">5. Health screening – seeking certain information relevant to health encounter <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">6. Immunity – able to fight off virus. <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">7. Health status – current state of a person’s health <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">8. Dose – amount of medication, vaccine, or treatment prescribed <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">9. Pandemic (see below) 10. Disease transmission - can be spread person to person (coughing, sneezing, and sometimes touching contaminated objects) || Prerequisite knowledge a healthcare worker needs to understand purpose and procedures required to perform successfully.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">** Concepts **

Learner needs to choose responses that also educate patients on the vaccine and the risks in order to facilitate informed consent on the part of the person receiving the vaccine. Participant should be able to correctly answer the following questions:

If-Then relationships between concepts || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. High Risk – if an individual meets certain criteria, they may be at an increased risk of disease or complications <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Contraindications – something that rules out or excludes an individual from a treatment (egg allergy vs egg-based vaccine) <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. Symptoms – physical states or indications that point toward the possibility of illness (e.g. fatigue, fever, chills, sore throat, cough) || Learner will need to demonstrate knowledge of these principles during screening phase.
 * What is the flu?
 * What is the difference between seasonal and H1N1?
 * I heard cases were down, why do I still need it?
 * How is it made?
 * Will it give me the disease?
 * Are you qualified to give me this vaccine?
 * What are the different types of vaccine?
 * What is thimerosol?
 * I am pregnant/breastfeeding; do I still need the vaccine?
 * Can I get seasonal and H1N1 at the same time?
 * Do I need a second dose?
 * Can my child have his\her other vaccinations today?
 * I forgot my shot record, how will I show my regular doctor that I got this vaccine?
 * What are the side effects?
 * Will the shot hurt?
 * I have had Guillain Barre Syndrome, should I get vaccinated?
 * I am allergic to eggs; they could kill me. Can I get the vaccine?
 * What do I do if I have a severe reaction?
 * How do I keep informed? ||
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">** Principles **

Decisions as to whether patient is eligible for vaccine, and if yes, which type and dose they should receive.

Learner must identify patients who are ill because the recommendation is to wait on vaccination if more than mild to moderate illness is present. || Step by step actions in a series || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Greet patient <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Confirm purpose (seeking vaccine) <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. Confirm patient is in eligible category for vaccine (if restricted) <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">4. Inform patient about H1N1 and the vaccinations <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">5. Provide documentation <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">6. Ask questions to determine any contraindications to vaccination and type of vaccine || Steps the volunteer is to take during patient encounter – the mechanics for the interaction components of the participant with the simulation.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">** Procedures **

Structure for building the technological basis that must allow the interactions and feedback to occur. || Natural or routine sequences of events || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Patient encounter – interaction between medical professional and patient seeking care and treatment. Includes communication, listening, diagnosis/treatment, documentation, clarification and maneuvering the psycho-social and emotional aspects of the encounter. <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. The body’s response to vaccination – likely resulting in immunity <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. Phases of pandemic – historically they hit in waves || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Stages of encounter from which the information communicated hopefully drive the correct outcome. <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. The goal of the patient and the learner. <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. Awareness to guide responses; although cases have decreased in past weeks officials are concerned that another wave may hit in January and February. Underlying motivation to receive vaccination – the threat is not over but it can be reduced with widespread vaccination. || Unpredictable happenings || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Patient encounter – despite the ‘usual’ progression of a visit, it all depends on the individuals (patient and provider) and the circumstances. <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Logistics <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. Outbreak status – increase, maintain, or decrease in disease spread. || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Patient presentation via video and reactions to selected responses from participant <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">a. No prep on patient identity or characteristics prior to encounter <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">b. Include unexpected questions or behaviors <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">c. House characters interrupt to quiz/explain a nuance that the learner may have overlooked that could impact patient outcome <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Possible injects include running out of vaccine or syringes || The backdrop for all the content || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Pandemic – global spread of novel virus that passes easily from person to person and to which most people do not have immunity <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Clinic location <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. The fictional world of the television series || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Simulation is situated in real-life, current context of the pandemic H1N1 influenza outbreak <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Princeton Plainsboro Teaching Hospital – clinic depicted in television series <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">3. Incorporates established aesthetic and story components that utilize fantasy as a motivating factor || Perspectives taken by actors within the context || <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"><span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">1. Clinician or other healthcare provider <span style="color: black; font-family: Arial; font-size: 10pt; mso-fareast-font-family: Arial; msofareastfontfamily: Arial; msolist: Ignore;">2. Working in new environment || Participant has to rely on prior experience of working in similar environments as a healthcare worker. (no orientation to basic duties or expectations – limit simulation solely to vaccination)
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">** Processes **
 * **<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Probabilities **
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">** Context **
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">** Vantage Points **

Circumstances of how the participant arrives in position covering the shift will be left ambiguous so simulation is adaptable to both staff and volunteers.

Utilizing fantasy world of House, but even if participant is unfamiliar the components (staff, clinic, procedures, purpose are consistent with typical health/medical environments. (Reduced acclimation time) ||